Harold & Alice Levy Loan Program
Agreement and Promissory Note
Personal Information (Please type or print neatly)1. Last Name First Name MI / 2. Social Security Number
3. Permanent Address / 4. Home Telephone
( ) / 5. Date of Birth (Month/Day/Year)
City State Zip Code / 6. Email Address
7. References: Recipient must provide two references with different addresses who will know how to contact Recipient in the future. The first reference should be a parent (if living) or other relative. (This information will be used to contact Recipients during the loan repayment period, if necessary.)
Name / A. / B.
Permanent Address
City, State, Zip Code
Area Code/Telephone number
Relationship to Borrower
<First Name> <Last Name> (subsequently referred to as the “Recipient”), understands and agrees that the purpose of the Harold & Alice Levy Loan Program is to encourage and provide loans to students in the Department of Communication at the University of Washington and foster opportunities for students that would otherwise be economically unattainable. Recipient understands and agrees to be bound by the terms of this Agreement and Promissory Note (subsequently referred to as the “Promissory Note”). As a participant in the Harold & Alice Levy Loan Program, Recipient represents that he/she intends to fulfill the “Obligations of the Recipient” as set forth below, and agrees that if he/she fails to do so he/she will be required to repay the then-outstanding principal amount of the loan provided under this Promissory Note (subsequently referred to as “loan(s)”), together with interest, under the terms set forth below, to the University of Washington (subsequently referred to as “the University”). Recipient understands that he/she has the right to accept, decline, or request a lower loan amount(s).
The principal amount of this Promissory Note is the total amount advanced under the Harold & Alice Levy Loan Program as set forth in the below:
AMOUNT OF LOAN and DISCLOSURE OF FINANCIAL CHARGES
AMOUNT FINANCED:The amount of credit provided *: / ANNUAL PERCENTAGE RATE:
The cost of credit at a yearly rate
Prior to Entering Repayment Status
0.00% / After Entering Repayment Status 3%
LATE CHARGES: / If a required loan payment is late, Recipient will be charged $5.00 after 20 days and additional $5.00 for each full month thereafter that such overdue payment remains outstanding.
PREPAYMENT: / There is no penalty for pre-payment.
ITEMIZATION OF AMOUNT FINANCED OF <Amount of Loan>
Provided directly or paid to the University of Washington on behalf of Recipient.
I. OBLIGATIONS OF THE RECIPIENT: The Recipient represents that he or she intends to fulfill Obligations of the Recipient as set forth below. If the Recipient fails to meet these obligations, the Recipient agrees to repay all outstanding loan amounts, with interest, in accordance with the terms of this Promissory Note. The Obligations of the Recipient are as follows:
1. Within 12 months from the issuance of the loan, Recipient must complete a service or research activity in accordance with the requirements of Section II, with pre-approval from the Department of Communication.
2. Recipient must remain enrolled in the University as a Communication major until completion of the service/research activity requirement or until graduation, whichever occurs first.
II. SERVICE/RESEARCH ACTIVITY REQUIREMENT: A proposed service or research activity must be submitted to and pre-approved by the Chair of the Department of Communication. To qualify for loan forgiveness, Recipient must complete a minimum of 100 hours in one of the following activities:
1. Serve on a voluntary basis with a governmental or non-profit organization (other than the University of Washington) providing either communication expertise, or mentoring, counseling and/or advising to persons interested in the field of communication; or
2. Complete and present independent research on a topic in communication under the supervision of a UW faculty member
III. QUALIFICATION FOR LOAN FORGIVENESS : If the Obligations of Recipient are met, the loan amount that Recipient is obligated to repay will be forgiven upon submission by the Recipient, and approval by the Chair of the Department of Communication, of a completed Levy Loan Program Certification Form.
IV. REPAYMENT: If the Recipient does not timely fulfill the Obligations of Recipient specified in Section 1 or submit a completed Levy Loan Program Certification Form as noted in Section III to the Department of Communication, the Recipient will enter Repayment Status and shall be required to repay all outstanding loan amounts plus interest in accordance with the payment schedule set forth below. Principal and interest shall be payable in U.S. dollars drawn on a U.S. bank. In the event a Recipient in repayment status fails to make a required payment, the University may institute legal action to enforce repayment and recover the costs of collection as well as attorney fees. In the event of legal proceedings, the University shall have the right to bring legal action in King County, Washington. The following applies to a Recipient in Repayment Status:
1. The Recipient shall make quarterly repayments until the outstanding loan principal and interest due are fully repaid. The first payment will be due the first day of the next quarter following the first date the Recipient is in default.
2. The maximum repayment period may not exceed 5 years (60 months) divided into 20 quarterly (every three months) payment periods. Payment of principal together with interest thereon and any charges shall be made in equal quarterly installments established by the University.
3. All payments and prepayments will be applied in the following order: First: late charges and collection costs; Second: outstanding interest; Third: outstanding principal.
4. The Recipient is responsible for making payments on time even if the Recipient does not receive a bill or repayment notice.
V. DEFERMENT: Recipient shall not be considered to be in Repayment Status if he or she is granted deferment of any the Obligations of Recipient specified in Section I. Requests for deferment must be submitted in writing to the Chair of the Department of Communication. The Chair (or his or her designee) may, in his or her sole discretion, approve a deferment of the Obligations of Recipient in circumstances where the facts presented demonstrate a compelling reason for such a deferment.
VI. INTEREST: Interest on the outstanding principal balance shall be calculated at the rate of 3% annually. The applicable rate as of the effective date of this Promissory Note is 3% (three percent) per annum. No interest is charged the Recipient until Recipient enters Repayment Status
VII. PREPAYMENT: The Recipient may prepay all or any part of the unpaid indebtedness at any time without additional penalty. Because interest is not computed in advance, no refund of unearned interest will be due, and none will be given on prepayment. Prepayment will, however, reduce the total amount of interest paid.
VIII. CANCELLATION: In the event of the Recipient’s death or permanent and total disability, any unpaid indebtedness under this Promissory Note shall be canceled.
IX. LATE AND COLLECTION CHARGES: A late charge of $5.00 may be charged on any payment received later than 20 days after the due date and an additional $5.00 may be charged for each full month thereafter that such overdue payment remains outstanding. In the event the Recipient fails to make a required payment within 30 days of the due date, the entire outstanding loan balance including all accrued interest shall, at the option of the University, become immediately due and payable. The Recipient promises to pay costs and expenses necessary for collection of any amount not paid when due (to the extent permitted by law), including reasonable attorneys’ fees, whether or not a lawsuit is commenced.
X. TAXES: The Recipient shall be solely responsible for all taxes that may be imposed upon Recipient for loan amounts received, imputed interest, or loan amounts and interest discharged pursuant to the terms of this Promissory Note.
XI. JURISDICTION AND VENUE: This Promissory Note shall be subject to and construed in accordance with the laws of the State of Washington. Venue for any cause of action arising under this Promissory Note shall be in King County Superior Court, King County, Washington.
XII. NOTIFICATION: The Recipient shall promptly notify the University, in writing, of any change in the Recipient’s name and/or address.
XIII. MISCELLANEOUS: This Promissory Note embodies the entire agreement between the Recipient and the University regarding the terms under which the loan amounts are provided to the Recipient and supersedes any and all agreements, contracts, understandings or representations, whether oral or written pertaining to such loan. A waiver on any particular occasion of the terms, obligations or conditions of this Loan Agreement and Promissory Note shall not be construed as a bar to or waiver of any such rights or remedies on any other occasion.
XIV. SEVERABILITY: If any provision of this Promissory Note should be found invalid, void or unenforceable by a court of competent jurisdiction, or so rendered by legislation or administrative action, the validity of the remainder of this Promissory Note shall not be affected and shall remain in full force and effect as if this Promissory Note had been executed in the absence of the portion held to be invalid, void or unenforceable.
By endorsement of warrants or by notification of disbursement(s) of the loan proceeds to the Recipient student account at the University of Washington, the Recipient acknowledges receipt of funds under the terms of this Promissory Note. The undersigned Recipient also agrees to: 1) use loan proceeds only for educationally related purposes and necessary living expenses; and 2) repay this loan in accordance with the terms of this Promissory Note.
Recipient Signature: My signature below certifies that I have received a copy of and have read and agree to the terms of this Harold and Alice Levy Loan Program Agreement and Promissory Note.
______
Signature of Recipient Date
University of Washington
By: ______
Date
Title ______
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